Discussion of public health and health care policy, from a public health perspective. The U.S. spends more on medical services than any other country, but we get less for it. Major reasons include lack of universal access, unequal treatment, and underinvestment in public health and social welfare. We will critically examine the economics, politics and sociology of health and illness in the U.S. and the world.

Tuesday, January 03, 2006

Weapons

I seem to be about the only person who remembers this, but the original reason why the U.S. invaded Iraq was not to bring freedom and democracy™ to the Greater Middle East™. Now that we are accomplishing that new mission by dropping bombs on residential neighborhoods on behalf of the Shiite fundamentalist theocracy that God called upon George W. Bush to install in that unhappy land, we might take the occasion of the new year to reflect on the hysteria over Weapons of Mass Destruction™ that infected the corporate media three years ago.

Now there happens to be a super-secret, special fact about Weapons of Mass Destruction™ that as far as I can tell, no politiican or reporter in the U.S. knows: we got 'em, so do lots of countries we’ve decided for now to call our friends, and we're busy developing new and more terrifying ones all the time. But for people we don't like to have them, or appear to want them, or even maybe develop knowledge that might enable them to make some of them someday, is EVIL -- which means we get to bomb or invade them.

But what exactly is a Weapon of Mass Destruction anyway? Take Ricin. Three years ago there seemed to be a new headline every day about somebody somewhere suspected of having ricin, or thinking about ricin, or possibly knowing how to make it. These reports included screaming hysterics about terrorist training camps in Iraq and al Qaeda cells in Europe. For some reason it was always called a "biological weapon." The Boston Globe even called it a "germ weapon," and refused to correct the report because, according to the Globe ombudsman, Congress had declared it to be one, and if the federal government says it's true, so does the Globe. Ricin is actually a plain, old fashioned poison that happens to be derived from a plant (castor beans) -- as are most common poisons. Cyanide, atropine, all the good murder mystery poisons, come from plants. Ricin’s claim to fame is potency by weight, but it's not particularly useful as a military or terrorist weapon. It’s a dry powder, not volatile. You could open a 50 pound bucket of it in the subway and it would just sit there. It's a useful way to knock off your mother-in-law, but there are plenty of other perfectly good ways to poison people, available at your corner hardware store.

Now let's talk about genuine biological weapons – pathogens such as anthrax. Anthrax is not contagious. The idea that a small quantity of anthrax spores could kill thousands or millions of people –which Colin Powell favored us with before the UN Security Council in February 2003 -- is, uh, a bit of a stretch. Powell’s calculations assumed that the exact minimum number of spores needed to cause disease could be distributed precisely into each individual's lungs. By the same sort of calculation, 50 pounds of TNT could kill thousands of people because you could divide it precisely into thousands of firecrackers and insert them into thousands of orifices.

If someone were to spray anthrax spores into the air, most of them would never be inhaled and would never harm anyone. (Did you know? Much of the soil in the Southwest United States is already contaminated with anthrax spores.) Only people unlucky enough to inhale a sufficient number, and to be susceptible (susceptibility varies hugely, for unknown reasons) will be affected. Anthrax can be used to sicken or kill a relatively small number of people, in most plausible scenarios. It's scary because you probably won't know you've been exposed until some time later, and if you don’t get the proper diagnosis in time the disease of inhalation anthrax is fatal, although the terror factor has notched down considerably, or should have, since we have learned that it is fully curable. As we have seen, creating anthrax contamination can cause a substantial economic cost and disruption, as well as kill or harm some people. The anthrax mailer demonstrated a technique of mass disruption that has unique features, no doubt about it. But a truck bomb is a more effective and more certain way to kill large numbers.

Then there are chemical weapons, another category of so-called Weapons of Mass Destruction (where ricin really belongs). The Aum Shinrikyo cult in Japan managed to kill 11 people by releasing sarin gas in the subway, but in 2003, a man killed hundreds in the subway in South Korea by starting a fire with a milk carton full of paint thinner. Chemical weapons aren’t even especially daunting as battlefield weapons because protective clothing and/or chemical antidotes render them ineffective, just as a vaccine defeats anthrax. No such protection is possible from high explosive and projectile weapons.

Don’t get me wrong – you can definitely kill people with anthrax or poison and that is a very bad thing to do. But think about it: sarin, ricin, anthrax – all these are Weapons of Mass Destruction, while cluster bombs, Daisy Cutters, MOABs, Fuel Air Explosives, Tomahawk cruise missiles, aircraft strafing cannons – the weapons that have already killed tens of thousands of Iraqi civilians and military conscripts, and razed entire cities, among other accomplishments – aren’t.

How come? Not because category A is inherently more massively destructive than category B. Rather, it’s because the U.S. military has a lot of those high explosive and projectile weapons, and the means to deliver them, and it uses them. The monopoly of massively destructive so-called "conventional" firepower by the world's military powers means we don't call those things Weapons of Mass Destruction.

So what about nukes? Those are definitely Weapons of Mass Destruction, by anybody’s definition, including mine. Well, it's okay for us to have them, and Israel, China, Russia, France, UK, and now Pakistan and India. (We're supposed to pretend that we don't actually know for sure whether Israel has them or not, by the way. But I don't play stupid make believe games just because AIPAC wants me to.) It's just not okay for anybody else to have them. So let's be clear about the terms of this discussion.

The whole point of the WMD category is not about what kinds of technologies do and do not inherently threaten the most horrible consequences. It’s about who gets to monopolize the use of deadly force. Nerve gas and anthrax do nothing to equalize the battlefield, in reality, but they make for good copy. And even though they seem to really scare people as potential terrorist weapons (we can worry about the exact definition of that another time) it isn’t clear why it’s less scary to contemplate being done in by a fertilizer bomb. Saddam is said to have gassed Kurdish civilians (with the blessing of Ronald Reagan and George Bush the First, so I guess poison gas wasn’t yet a WMD back then) which is indeed a terrible crime. So it would have been alright if he had blown them to pieces instead?

Weapons of Mass Destruction means weapons that relatively weak states or non-state actors might obtain, that we don't want them to have, or that we really don’t care whether they have or not, but which create a useful excuse for belligerence. High explosives can do a lot of damage even without sophisticated delivery systems, as Tim McVeigh and others have proved, but they really become WMDs when married to guided missiles, B1-bombers, and tanks.

So let’s drop this bogus dichotomy. There aren’t two kinds of weapons in the world: Weapons of Mass Destruction, that only we are allowed to have, because we can be trusted not to use them; and every other kind of weapon, that it’s okay for anybody to have even if most people can’t afford the best ones. Possessing sarin or anthrax wouldn’t have made Saddam a threat to his neighbors, and certainly not to the United States. He was militarily impotent with or without them. The lie was not only that he had such weapons, but that it even mattered.